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AHIP Certification Version 2 All New Qs & As for A++ Exam - Guaranteed Pass!Davis is 52 years old and has recently been diagnosed with end- stage renal disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What should you tell him?
Question 1: What should you tell Davis about obtaining
Medicare coverage given his diagnosis of end-stage renal disease (ESRD) and upcoming dialysis?
CORRECT ANSWER : He may sign-up for Medicare at any
time however coverage usually begins on the fourth month after dialysis treatments start.
Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap, Incorporated. Smallcap has a workforce of 15 employees and offers employer-sponsored healthcare coverage. Juan is a naturalized citizen and has contributed to the Medicare system for over 20 years. Juan asks you if he will be entitled to Medicare and if he enrolls how that will impact his employer-sponsored healthcare coverage. How would you respond?
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Question 2: How would you respond to Juan Perez’s questions
about his entitlement to Medicare and the impact of enrollment on his employer-sponsored healthcare coverage?
CORRECT ANSWER : Juan is likely to be eligible for Medicare
once he turns age 65 and if he enrolls Medicare would become the primary payor of his healthcare claims and Smallcap does not have to continue to offer him coverage comparable to those under age 65 under its employer-sponsored group health plan.
Moy's wife has a Medicare Advantage plan, but he wants to understand what coverage Medicare Supplemental Insurance provides since his health care needs are different from his wife's needs. What could you tell Mr. Moy?
Question 3: What could you tell Mr. Moy about the coverage
provided by Medicare Supplemental Insurance?
CORRECT ANSWER : Medicare Supplemental Insurance
would help cover his Part A and Part B deductibles or coinsurance in Original Fee-for-Service (FFS) Medicare as well as possibly some services that Medicare does not cover.
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Peňa is 66 years old, has coverage under an employer plan, and will retire next year. She heard she must enroll in Part B at the beginning of the year to ensure no gap in coverage. What can you tell her?
Question 4: What can you tell Peňa about enrolling in Medicare
Part B given her current coverage under an employer plan and upcoming retirement?
CORRECT ANSWER : She may enroll at any time while she is
covered under her employer plan, but she will have a special eight-month enrollment period after the last month on her employer plan that differs from the standard general enrollment period, during which she may enroll in Medicare Part B.
Chen will be 65 soon, has been a citizen for twelve years, has been employed full time, and paid taxes during that entire period. She is concerned that she will not qualify for coverage under Part A because she was not born in the United States.What should you tell her?
Question 5: What should you tell Chen about her eligibility for
Medicare Part A given her citizenship and work history?
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CORRECT ANSWER : Most individuals who are citizens and
age 65 or over are covered under Part A by virtue of having paid Medicare taxes while working, though some may be covered as a result of paying monthly premiums.
Gonzalez is enrolled in Original Medicare and has a Medigap policy as well, but it provides no drug coverage. She would like to keep the coverage she has but replace her existing Medigap plan with one that provides drug coverage. What should you tell her?
Question 6: What should you tell Gonzalez about replacing her
existing Medigap plan with one that provides drug coverage?
CORRECT ANSWER : Mrs. Gonzalez cannot purchase a
Medigap plan that covers drugs, but she could keep her Medigap policy and enroll in a Part D prescription drug plan.
West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through massage therapy. She is concerned about whether or not Medicare will cover these items and services. What should you tell her?